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Jae Hwan Cho, Jae Hyup Lee, Kwang Sup Song, Jae-Young Hong, Yoon-Suk Joo, Dong-Ho Lee, Chang Ju Hwang, Choon Sung Lee
BACKGROUND: Failed back surgery syndrome (FBSS) is a frequently encountered disease entity following lumbar spinal surgery. Although many plausible reasons have been investigated, the exact pathophysiology remains unknown. Various medications, reoperations, interventions such as spinal cord stimulation, epidural adhesiolysis or epidural injection, exercise therapy, and psychotherapy have been suggested treatment options. However, the evidence of the clinical outcome for each treatment has not been clearly determined...
January 2017: Pain Physician
Przemyslaw M Waszak, Marta Modrić, Agnieszka Paturej, Stanislav M Malyshev, Agnieszka Przygocka, Hanna Garnier, Tomasz Szmuda
Failed back surgery syndrome (FBSS) is complex and recurrent chronic pain after spinal surgery. Several important patient and surgery related risk factors play roles in development of FBSS. Inadequate selection of the candidates for the spinal surgeries is one of the most crucial causes. The guidelines suggest that conservative management featuring pharmacologic approaches and rehabilitation should be introduced first. For therapy-refractory FBSS, spinal cord stimulation (SCS) is recommended in selected patients...
December 2016: Asian Spine Journal
Zafeer Baber, Michael A Erdek
The treatment of failed back surgery syndrome (FBSS) can be equally challenging to surgeons, pain specialists, and primary care providers alike. The onset of FBSS occurs when surgery fails to treat the patient's lumbar spinal pain. Minimizing the likelihood of FBSS is dependent on determining a clear etiology of the patient's pain, recognizing those who are at high risk, and exhausting conservative measures before deciding to go into a revision surgery. The workup of FBSS includes a thorough history and physical examination, diagnostic imaging, and procedures...
2016: Journal of Pain Research
Ki Byung Park, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Jun-Hwan Lee, Kyung-Min Shin, Byung-Cheul Shin, Jae-Heung Cho, In-Hyuk Ha
STUDY DESIGN: Prospective observational 1-year study OBJECTIVE.: To determine minimum clinically important difference (MCID) and substantial clinical benefit (SCB) of outcome measures in failed back surgery syndrome (FBSS) patients, as these metrics enable assessment of whether and when an intervention produces clinically meaningful effects in a patient SUMMARY OF BACKGROUND DATA.: Several methods have been devised to quantify clinically important difference, but MCID and SCB for FBSS patients has yet to be determined...
October 25, 2016: Spine
Frank Wille, Jennifer S Breel, Eric W P Bakker, Markus W Hollmann
OBJECTIVES: To examine whether converting from conventional Spinal Cord Stimulation (SCS) to High Density (HD) SCS reduces neuropathic pain over a period of 12 months in patients with failed SCS therapy. METHODS: Retrospective, open label, single center, consecutive case series of 30 neuropathic pain patients (Failed Back Surgery Syndrome [FBSS], Complex Regional Pain Syndrome [CRPS], and polyneuropathy [NP]). Patients with an initial adequate response to conventional SCS, but in whom pain increased over time, were included (Numeric Rating Scales [NRS] >6)...
January 2017: Neuromodulation: Journal of the International Neuromodulation Society
Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVE: To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome. METHODS: In 21 patients who underwent paddle lead SCS at T9 (3-column, n = 9; 5-column, n =12) for failed back surgery syndrome, a 12-month follow-up numerical rating scale, percent pain relief, and computed tomography assessment of contact angle and percent reduction of T9 canal area were investigated...
January 2017: World Neurosurgery
Ciara Clancy, Alison Quinn, Fiona Wilson
PURPOSE: Four to fifty percent of patients will develop Failed Back Surgery Syndrome (FBSS) following lumbar spine surgery. Repeated surgeries lead to escalating costs and subsequent decreases in success rate. Much of the research to date has focused on the psychosocial factors associated with FBSS. All factors including physical and pathological aetiologies should be examined. These factors may be independent, co-exist with or predispose patients to the psychological factors associated with FBSS...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
Hans-Raimund Casser
Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment)...
September 2016: Der Orthopäde
A S Nikitin
This review provides current data on the failed back surgery syndrome (FBSS) of lumbar degenerative disease. The full range of complications forming this term is described. The data on the frequency and risk factors of various forms of FBSS are presented. General symptoms and diagnosis of the main FBSS forms are described. The questions of prevention and treatment of FBSS are considered.
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Kliment Gatzinsky, Roald Baardsen, Hendrik P Buschman
OBJECTIVE: To evaluate the effectiveness and safety of percutaneous octapolar (8-contact) leads in spinal cord stimulation (SCS) treatment of failed back surgery syndrome (FBSS) patients who have not reached their therapy goals with other treatment interventions. METHODS: Our prospective, multicenter, open-label, nonrandomized study included 93 patients ≥ 18 years of age suffering from chronic (≥ 6 months), intractable pain predominantly in the legs. Patients implanted with octapolar lead(s) and a neurostimulator after a successful test trial were followed for 12 months...
July 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
Ali Yavuz Karahan, Nilay Sahin, Akın Baskent
BACKGROUND: Failed back surgery syndrome (FBSS) is a condition characterized by persistent pain following back surgeries. OBJECTIVE: To determine the effects of different exercises programs in FBSS. METHODS: A Single-blind, randomized, controlled trial designed. One hundred participants with failed back surgery syndrome were randomly assigned to three different exercises groups (Isokinetic, Dynamic lumbar stabilization (DLS), and home exercises (HE) groups) and a control group...
June 17, 2016: Journal of Back and Musculoskeletal Rehabilitation
Richard L Weiner, Anthony Yeung, Carlos Montes Garcia, Laura Tyler Perryman, Benjamin Speck
OBJECTIVES: Test a miniaturized neurostimulator transforaminally placed at the dorsal root ganglion (DRG) and evaluate the device's safety and efficacy in treating failed back surgery syndrome (FBSS) low back pain. DESIGN: Pilot, two-phase study. SUBJECTS: Eleven subjects with chronic intractable neuropathic trunk and/or lower limbs pain were included. METHODS: The system consisted of an implantable, miniaturized stimulator, provided by Stimwave Technologies (Freedom-4) and an external transmitter...
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
N P Denisova, D Yu Rogov, D A Rzaev, E A Khabarova, A B Dmitriev
AIM: The study objective was to estimate the efficacy of chronic epidural spinal cord stimulation in the treatment of patients with neuropathic pain syndrome. MATERIAL AND METHODS: A system for chronic spinal cord stimulation (St. Jude) was implanted to 75 patients with neuropathic pain syndrome. Fifty three (70.7%) patients were diagnosed with failed back surgery syndrome (FBSS); 9 (12.0%) patients had complex regional pain syndrome type II; 4 (5.3%) patients had diabetic polyneuropathy of the lower limbs; 3 (4...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Bruno Bordoni, Fabiola Marelli
Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon), or in the postintervention phase in relation to infections or biomechanical alterations...
2016: Journal of Pain Research
Salim M Hayek, Elias Veizi, Michael Hanes
BACKGROUND: Intrathecal (IT) pumps have become a valuable tool in managing intractable non-cancer pain. The purpose of this study was to evaluate the efficacy of using a rigorous treatment algorithm for trialing and implanting IT pumps with hydromorphone and bupivacaine in managing a more homogeneous population of post-laminectomy syndrome or failed back surgery syndrome (FBSS) patients. METHODS:  This is a retrospective analysis of FBSS patients with chronic intractable back pain implanted with IT pumps delivering hydromorphone and bupivacaine...
March 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Thomas M Kinfe, Bogdan Pintea, Carolina Link, Sandra Roeske, Erdem Güresir, Ági Güresir, Hartmut Vatter
BACKGROUND: Conventional spinal cord stimulation (SCS) exhibits pain relief and improved quality of life in refractory failed back surgery syndrome. However, patients suffering from predominant back pain failed to achieve a favorable neuromodulation outcome. Currently, two new stimulation concepts, the burst and the HF10 stimulation paradigms successfully suppress intractable back pain levels in this difficult-to-treat subgroup. To date, literature data comparing both stimulation patterns is lacking...
April 2016: Neuromodulation: Journal of the International Neuromodulation Society
Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
Lumbar diskography (LD) is frequently used in the evaluation of patients with degenerative disk disease and diskogenic low back pain. Its safety and diagnostic accuracy are a topic of debate. No study has evaluated the efficacy of LD within the clinically distinct workers' compensation population. Within this setting, the authors wished to determine the effect of undergoing LD before diskogenic fusion on rates of postoperative failed back surgery syndrome (FBSS). Also, the authors compared opioid analgesic use between patients undergoing LD and patients not undergoing LD...
November 2015: Orthopedics
Hari Gopal, Joseph Fitzgerald, Connail McCrory
BACKGROUND: Spinal cord stimulation (SCS) is used for the treatment of chronic neuropathic pain, a notoriously difficult condition to treat. Failed Back Surgery Syndrome (FBSS) and Complex Regional Pain syndrome (CRPS) remain the strongest indications. Funding remains a difficult issue and the use of trial of stimulation is the traditional method of ensuring best outcomes from implantation. METHODS: A retrospective and consecutive review of 80 cases of spinal cord stimulation for patients with a diagnosis of FBSS and CRPS having undergone prior comprehensive medical management and interventional treatment with no sustained benefit...
2016: Journal of Back and Musculoskeletal Rehabilitation
Burak Duruk, Hanife Özlem Sertel Berk, Ayşegül Ketenci
OBJECTIVES: The aim of this study was to investigate whether Fibromyalgia and Failed Back Surgery Syndromes (FMS-FBSS) may be evaluated under the single heading of Functional Somatic Syndromes (FSS) with respect to their symptomatological characteristics such as intensity, frequency, age of onset, duration, painful areas, fear of pain, and pain coping styles; familial characteristics such as family history of chronic medical illness, psychopathology and pain; and psychological characteristics such as manner of dealing with pain, fear of pain, alexithymia, symptom interpretation, somatosensory amplification and depression...
2015: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Rebecca A Sanders, Susan M Moeschler, Halena M Gazelka, Tim J Lamer, Zhen Wang, Wenchun Qu, Bryan C Hoelzer
INTRODUCTION: Spinal cord stimulators (SCS) are used to treat various chronic pain states. Establishing patient outcomes in terms of pain control, opioid medication use, and overall satisfaction is vital in maintaining SCS's role in clinical practice. METHODS: All patients who underwent SCS implantation between January 2001 and December 2011 at a tertiary academic pain medicine center were included if he or she underwent permanent cervical or thoracolumbar dorsal column SCS implantation and age was 18 or greater...
September 2016: Pain Practice: the Official Journal of World Institute of Pain
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